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The efficacy of mobile application use on recall of surgical risks in nasal bone fracture reduction surgery

  • Kim, Choong Hyeon;Cheon, Ji Seon;Choi, Woo Young;Son, Kyung Min
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.41-47
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    • 2018
  • Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

Fungiform Papillae and its Correlation with Rome III Classification and Spleen Qi Deficiency in Functional Dyspepsia (기능성 소화불량증 환자에서 로마기준 III 아형분류 및 脾氣虛證과 심상유두 수의 상관성 분석)

  • Choi, Jane;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.308-322
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    • 2015
  • Objectives: Whether there exists a distinct pathogenesis in subgroups of functional dyspepsia (FD), the classification of epigastric pain syndrome (EPS), and postprandial distress syndrome (PDS) remains controversial. We aimed to investigate the number of fungiform papillae (FP) in the subgroups of FD and its correlation with the severity of dyspepsia symptoms and spleen qi deficiency. Methods: Patients with FD were enrolled from August to November 2014. All patients were evaluated using a questionnaire and divided into 2 groups according to the Rome III criteria for FD. The severity of dyspepsia symptoms and spleen qi deficiency were separately assessed by Nepean Dyspepsia Index-Korean (NDI-K) version and Spleen qi deficiency questionnaire (SQDQ). The number of FP was measured on the anterior part of tongue, within an area of 9 mm 2, using a digital cam Results: The NDI-K score, SQDQ score, and number of FP in the EPS group were significantly greater than those in the PDS group. Also, the EPS group had more patients diagnosed with spleen qi deficiency. The number of FP showed a significant positive correlation with epigastric pain and burning. Furthermore, the number of FP was significantly associated with the score of some items in NDI-K and SQDQ, even though not with the total score. Conclusions: Thus, measurement of the number of FP could be a new evaluation indicator for allocation into FD subtypes and to investigate the severity of dyspepsia symptoms and spleen Qi deficiency reflecting visceral hypersensitivity.

A Statistical Analysis of Outpatients in Ophthalmology and Otolaryngology of Korean Medicine at Kyung Hee University Korean Medicine Hospital in 2018-2022 (2018-2022년 경희대학교 한방병원 한방 안이비인후과 외래환자에 대한 통계분석)

  • Byunghyun Kim;YeEun Hong;EunKyung Lee;Heejae Lee;Kyuseok Kim;HaeJeong Nam;YoonBum Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.2
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    • pp.1-13
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    • 2024
  • Objectives : The purpose of this study is to figure out the changes in sex, age, disease distribution of outpatients in ophthalmology and otolaryngology of Korean medicine. Methods : We analyzed the medical records of 2,834 outpatients who visited department of ophthalmology and otolaryngology of Korean medicine at Kyung Hee university Korean medicine hospital between 2018 and 2022. And we compared the results with those of studies from 2000, 2007, and 2017, considering sex, age, and diseases. Results : 1. The total number of patients in ophthalmology and otolaryngology increased compared to 2012-2016, with a higher proportion of patients aged 50 and above in all departments. 2. The number of patients in ophthalmology has been continuously decreasing since 1996-1998. 3. The number of patients in otology has increased significantly compared to 2012-2016, with a trend towards a lower proportion of tinnitus and hearing loss. 4. The number of patients in rhinology has not recovered from the significant decrease in 2012-2016, and rhinitis continues to constitute a significant proportion. 5. The number of patients in laryngology has increased significantly compared to 2012-2016, with a trend towards a less proportion of laryngopharyngitis. Conclusion : The active utilization of diagnostic equipment, further research and promotion of Korean medicine treatment for ophthalmology and otholaryngology diseases are essential for expanding the treatment domain within ophthalmology and otolaryngology of Korean medicine.

Clinical Characteristics and Prognostic Factors of Geriatric Patients Involved in Traffic Accidents (노인 교통사고의 임상 특성 및 예후 예측인자)

  • Kim, Tae Su;Lee, Kang Hyun;Kim, Tae Hoon;Kim, O Hyun;Cha, Yong Sung;Cha, Kyung Chul;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.101-107
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    • 2014
  • Purpose: Recently, the population of elderly people has been increasing rapidly all over the world. The social activities of the aging population have increased, which has also increased the number of elderly patients injured in traffic accidents. Thus, we analyzed the characteristics of elderly patients involved in traffic accidents. Methods: This study was conducted retrospectively from July 2008 to March 2009 among trauma patients involved in traffic accidents who visited Wonju Severance Christian Hospital. Patients under 18 years of age and pregnant patients were excluded. We divided the patients in two groups, a geriatrics group and an adult group on the basis of an age of 65. We compared the types of traffic accidents, the locations of the accidents, the behaviors of the patients at the times of the accidents, the use of seat-belts, and alcohol consumption between the two groups. We calculated the Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) for each group. Results: Total number of the included patients was 903, and the number of elderly patients was 181 (mean age: $71.7{\pm}4.9$ years old). There were no significant differences in the initial vital signs, GCS (Glasgow Coma Scale), and RTS between the two groups. There were differences in the types and the locations of the crashes, the behaviors of the patients at the times of the accidents, the use of seat belts, and alcohol consumption between the two groups (p<0.05). The average ISS of the geriatric group was higher than that of the adult group ($9.66{\pm}10.11$ vs. $6.59{\pm}8.99$, p=0.004). The mortality was higher in the geriatric group (n=17,9%) than in the adult group (n=23,2%) (p=0.004). Conclusion: The numbers of mortalities and surgical procedures were greater within the elderly group than the adult group. The average ISS was higher in the geriatric group than in the adult group. The severity of injuries due to traffic accidents was higher in the geriatric group than it was in the adult group.

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

  • Jo, Dae-Jean;Jun, Jae-Kyun;Kim, Ki-Tack;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.412-418
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    • 2010
  • Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

THE EFFECT OF TOPICAL FLUORIDE APPLICATION ON THE NUMBER OF SALIVARY STREPTOCOCCUS MUTANS IN ORTHODONTIC PATIENTS (불소도포가 교정환자의 타액내 Streptococcus mutans 수에 미치는 영향)

  • Bae, Weon-Jeong;Kim, Jin-Beom;Kim, Hyung-Il;Shon, Woo-Sung
    • The korean journal of orthodontics
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    • v.24 no.1 s.44
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    • pp.181-192
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    • 1994
  • The effect of topical application on the number of S. mutans was tested in a group of 44 orthodontic patients (mean age, 12Y 3M). They were divided into 5 groups according to the method using NaF and $SnF_2$. The number of S. mutans CFU were counted in stimulated saliva of each subject at baseline, and after one, two, three, and eight weeks. The following results were obtained. 1. In NaF rinsing group, and NaF topical application and NaF rinsing group, the number of S. mutans per ml saliva was not significantly changed. 2. In $SnF_2$ topical application group, and $SnF_2$ topical and NaF rinsing group, the number of S. mutans per ml saliva was significantly reduced. 3. After 8 weeks, there were no significant reduction of the number of S. mutans in comparison with baseline.

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Evaluation of Nutritional Improvement by Total Parenteral Nutrition Guideline in Early Malnourished Inpatients (입원초기 영양불량 환자의 TPN 지침에 따른 영양개선 평가)

  • Cha, Yun Young;Kim, Jung Tae;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.365-372
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    • 2013
  • Background: Malnutrition of inpatients has been associated with higher morbidity, mortality, cost, and longer hospital stay. Total parenteral nutrition (TPN) therapy plays an important role in decreasing morbidity and mortality among critical inpatients in hospitals, and has been commonly used to improve clinical outcomes. However, only a few studies were conducted regarding patients' nutritional improvement by TPN. Method: This study therefore evaluated the changes in nutritional parameters by TPN therapy for early malnourished inpatients. Data from early malnourished inpatients who were treated with TPN therapy between January 2012 and June 2013 at the ${\bigcirc}{\bigcirc}$ university Hospital were studied retrospectively. Information regarding sex, age, underlying diseases, division, TPN (peripheral and central), and changes in nutritional parameters were collected by reviewing electronic medical records. The criteria for evaluation of the changes in nutritional parameters were included physical marker, body mass index (BMI), and biochemical markers, including albumin (Alb), total lymphocyte count (TLC), and cholesterol. Nutritional parameters were collected three times: pre-TPN, mid-TPN and end-TPN. A total of 149 patients (peripheral, 97; central, 52) was evaluated. Results: In all patients, the malnutrition number was significantly decreased following the complete TPN therapy (peripheral patients, pre-TPN: $3.33{\pm}0.12$, mid-TPN : $3.06{\pm}0.17$, and end-TPN: $2.85{\pm}0.21$ (p < 0.05); central patients, pre-TPN: $3.38{\pm}0.11$, mid-TPN: $3.06{\pm}0.13$, and end-TPN: $2.75{\pm}0.21$ (p < 0.05). The malnutrition number means number of nutrition parameters below normal range of malnutrition. In addition, all of the four nutritional parameters (BMI, Alb, TLC and cholesterol) were increased with duration of TPN periods for all patients, and the changes in the early stage were larger than in the late stage (p < 0.05). The nutritional parameters of non-cancer patients were increased to a greater extent compared to cancer patients with longer TPN therapy, but it was not significant. The nutritional parameters of younger patients (50-60 years) were also increased more than of older patients (70-80 years), but it was not significant. Conclusion: In conclusion, the TPN therapy decreases malnutritional status and improves nutritional parameters in malnourished patients, thereby decreasing morbidity and mortality. The combined evaluation of all four nutritional parameters is more accurate for nutritional assessment than a single one.

The Comparison of Computerized Tomography Utilization between before and after Coverage of Medical Insurance (전산화 단층촬영의 의료보험 급여전후 촬영건수 비교)

  • Suh, Shin-Il;Kim, Han-Joong;Park, Eun-Cheol;Sohn, Myong-Sei;Kim, Dong-Kee
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.121-133
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    • 1998
  • We analyzed volume changes in the computerized tomography(CT) and the magnetic resonance imaging(MRI) utilizations. These two volumes are comparative because CT has been covered by the Medical Insurance from the beginning of 1996, however, MRI has not been covered up to now. We investigated 80 hospitals which afforded a facility of CT by the end of 1994. For the comparison of CT utilization, we selected two periods. The first period was from January to June of 1995, in which CT had not been covered by the Medical Insurance and the second period was from January to June of 1966, in which CT had been covered. The information we obtained were characteristics of hospitals, patients numbers per month, monthly uses of CT and MRI, and payments of CT claims, etc. After the Medical Insurance coverage, the number of CT uses per 1,000 patients were increased from January to March, however, was decreased from April to June in 1996 compared to the same periods of 1995. the number of CT uses in clinics were large than those in tertiary hospitals. The number of CT uses in small cities were larger than those in big cities. On the other hand, the number of MRI uses per 1,000 patients did not changed from January to May and was increased from June in 1996 compared to the same periods of 1995. These results showed the substitutional relationship of CT and MRI uses. After the insurance coverage for CT, the utilization of CT was increased because patients payed less than before. However, insurers restricted the payments to the CT claims. This impact might explain the substitutional relationship between CT and MRI.

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Dual trigger in normally-responding assisted reproductive technology patients increases the number of top-quality embryos

  • Sukur, Yavuz Emre;Ulubasoglu, Hasan;Ilhan, Fatma Ceylan;Berker, Bulent;Sonmezer, Murat;Atabekoglu, Cem Somer;Aytac, Rusen;Ozmen, Batuhan
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.300-305
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    • 2020
  • Objective: The feasibility of a gonadotropin-releasing hormone agonist (GnRHa) trigger in normal responders is still a matter of debate. The aim of this study was to compare the number of mature oocytes, the number of good-quality embryos, and the live birth rate in normal responders triggered by GnRHa alone, GnRHa and human chorionic gonadotropin (hCG; a dual trigger), and hCG alone. Methods: A retrospective cohort study was conducted at the infertility clinic of a university hospital. Data from 200 normal responders who underwent controlled ovarian hyperstimulation and intracytoplasmic sperm injection with a GnRH antagonist protocol between January 2016 and January 2017 were reviewed. The first study group consisted of patients with cycles triggered by GnRHa alone. The second study group consisted of patients with cycles triggered by both GnRHa and low-dose hCG (a dual trigger). The control group consisted of patients with cycles triggered by hCG alone. Results: The groups were comparable in terms of demographics and cycle characteristics. The numbers of total oocytes retrieved and metaphase II oocytes were similar between the groups. The total numbers of top-quality embryos were 3.2±2.9 in the GnRHa group, 4.4±3.2 in the dual-trigger group, and 2.9±2.1 in the hCG group (p=0.014). The live birth rates were 21.4%, 30.5%, and 28.2% in those groups, respectively (p=0.126). Conclusion: In normal responders, a dual-trigger approach appears superior to an hCG trigger alone with regard to the number of top-quality embryos produced. However, no clinical benefit was apparent in terms of live birth rates.

Differences in electric potential of meridian system(5) - Comparing electrical potentials of patients with shoulder lesions - (견비통 환자의 침 치료 전후 12경맥 전위측정 연구(5))

  • Nam, Bong-hyun;Choi, Hwan-soo
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.12-23
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    • 2002
  • Objective : Assuming That the Characteristic of Meridian System Has been Similar to This of Electric Potentials in Human Body And that Measurements of Electric Potential at Well(井穴) and Sea(合穴) Points in Branches of the Twelve Meridians(WSBTM) Will Be Representative of Measurements of the Twelve Meridians, to Measure the Electric Potentials of 21 Patients with Shoulder Lesions, And Aching of Shoulder and Arm(肩臂痛)(ASA), to Be Differences in Electric Potentials of Patients Between Before And After Acupuncture Treatment, And Then to Find out the Characteristic of Meridian System in Patients with Shoulder Lesions. Methods : Electric Potentials of Well And Sea Points in the Meridians in Twenty one Patients with ASA Diagnosed by Both x-ray And Self View on Pain at Shoulder And Arm were Repeatedly Measured by Physiograph(PowerLab) at Before And after Acupuncture Treatment, Respectively. Measurements of Those Electrical Potentials Were Analyzed by Factor Analysis. Results : The Electric Potentials of WSBTM At the Left Side Before Acupuncture Treatment Were Divided Into Five Factors, But Those After Acupuncture Treatment Were Done Into Four Factors. On The Other Hand Those At the Right Side Before Acupuncture Treatment Were Divided Into Four Factors, The Number of Factors After Acupuncture Treatment Was Five. Conclusions : In Conclusions, The Number of Factors Before Acupuncture Treatment Are Different from Those After Acupuncture Treatment. In the Results The Effect of Acupuncture Treatment May be Reflected in Measurements of Electric Potential at WSBTM.

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